Gutierrez C A, Just-Viera J O
Am Surg. 1983 Feb;49(2):113-5.
A series of seven patients diagnosed as having radiation induced pericarditis were reviewed and compared to those reported in the literature. They constituted 6.8 per cent of all patients with the diagnosis of pericarditis seen in a five-year period. These patients had the diagnosis proven by autopsy or by the absence of tumor cells from the pericardial fluid and/or surgical biopsy. The echocardiogram and cardiac catheterization were found to be specific diagnostic tools. Recommendations are made for a therapeutic approach to these patients. The diagnosis of this condition depends on a high index of suspicion, and close follow-up of patients who have received intense radiotherapy to the chest. Recommendations are made for prophylaxis. We challenge the pessimistic approach towards the cancer patient who develops recurrent pericardial fluid or pleural effusion due to radiation induced pericarditis. We advocate an aggressive diagnostic approach and therapy which should be related to the degree of hemodynamic impairment.
回顾了7例被诊断为放射性心包炎的患者，并与文献报道的病例进行了比较。他们占五年内诊断为心包炎的所有患者的6.8%。这些患者的诊断通过尸检或心包积液和/或手术活检中无肿瘤细胞得以证实。超声心动图和心导管检查被发现是特异性的诊断工具。针对这些患者提出了治疗方法的建议。这种疾病的诊断取决于高度的怀疑指数，以及对接受过胸部高强度放疗患者的密切随访。提出了预防建议。我们对因放射性心包炎而出现复发性心包积液或胸腔积液的癌症患者持悲观态度提出质疑。我们主张采取积极的诊断方法和治疗措施，这应与血流动力学损害程度相关。
